You know you've had a bad night when you wake up with a vagina full of tacks. Yes, thumbtacks. And how exactly did you remove the tacks from her vagina? "Very carefully," says the emergency-room doctor who had to perform this task.

Right. Let me rephrase that: "How the hell does a woman end up with a vagina full of thumbtacks?!"

Ah, now there's a good question, except our doctor doesn't have an answer because the woman herself had no idea how they got there. "She's psychotic and suffers occasional blackouts where she loses consciousness for days at a time and wakes up with no recollection of how she got wherever she ends up." And, in this case, with her vagina full of tacks. How absolutely terrifying is that?

Welcome to Emergency - though they never showed cases like this on that old show from the '70s.

The emergency doctor I'm speaking with tells me a lot of the patients who come in with bizarre sex injuries are often psychotic. Like the Tack Lady.

Or Porcupine Man. The doctor is a little hesitant talking about this guy because he's a regular who likes to do a lot of cocaine and then play My Penis, the Pin Cushion. "He comes in with at least 100 needles stuck into the end of his penis." Apparently, he finds this stimulating, that is until the swelling of his penis wrecks the fun.

For all their pride in their penises, some guys sure have a strange way of showing it, like the guy who decided he'd slash his penis into ten bacon-slice-like pieces.

The reconstruction was considerable, the doctor tells me. We can rebuild it; we have the technology. "It took at least four surgeries." He even has the pictures. He uses them in lectures to show his students the wonders of reconstructive surgery. So just how reconstructive was it? "He could pee again by the time he left. That's all I saw."

Why exactly would a mature 60-year-old guy decide to slice up his penis with a paring knife, anyway? "He said it felt good." Until it started bleeding so much he had to wrap it up in gauze and towels and head to emergency for some pain relief and a new penis. I don't think I need to say this but I will: Do not try this at home, kids. Same goes for the needle business.

Of course, not everyone who comes in with sexually related injuries is psychotic. Sometimes they're just nuts, like the 16-year-old who came in with burns all over the end of his penis. Turns out he had genital warts and was too embarrassed to go to a doctor about it. He'd heard they burn them off, so he decided to try it himself. Except they don't usually use hot knives down at the STD clinic. If there ever was a good argument in favour of losing the stigma that surrounds STDs; this guy should be the poster boy.

"Then there's things like your standard dildo retrievals," the doc continues. "But that's so common." Hmm... maybe in your circles. "We did do one unusual vibrator removal on a guy," the doctor adds, suddenly perking up. It had lodged inside his butt and was still on. They managed to get inside and shut it off, but because it was in backwards (apparently he'd decided to pretend it was a double ended dildo and used it with someone else) they had to surgically remove it from the inside via his bowel. Ouch!

This stuff's gotta get to you after awhile. "I've stuck my finger into 1,000 asses and as many vaginas and after awhile, it just becomes another body injury," the doctor tells me. "There is nothing sexual about it. You're like, Okay, this one is a tack receptacle and this one is me getting some. It's pretty easy to differentiate."

Just in case anyone has any doubts, he makes sure there's a nurse in the room with him whenever he has to do a rectal or vaginal examination.

Some things can still shock him, though, like one young couple who came in complaining that the young woman was throwing up. After assessing her symptoms, the doctor asked if there was any chance she might be pregnant. "No, impossible, I'm on the Pill." The doctor asked her if she'd missed any pills. "No, I've taken all mine. Honey, have you missed any of yours?" she asked her young boyfriend. "No, I've taken all mine."

The doctor almost had to leave the room so great was his shock when he realized what was going on. Apparently, to be fair, so she wouldn't have to bear the full responsibility of birth control, they were sharing the pills. Hey, more guys should be so considerate about sharing the duties. But the lack of education is a little astounding. And you have to wonder how long it would be before he showed up in the emergency asking the doc about his new breasts.

The doctor tells me he's also seen a few, what he calls, "missed the hole" injuries. That is, bruised or swollen penises that missed their target during intercourse and slam-dunked themselves right into her pubic bone. What's worse is when you hear it snap. He admits he's never seen a broken one, but some of his colleagues have shared a few busted-penis stories over lunch in the cafeteria.

If it's only bruised, however, there's not much he can do. "I give them some pain relief, tell them to stroke it every day, and wait for it to heal."

Priapism is another common male sexual emergency. And this is one hard-on you won't be proud of. Having an erection for hours on end is no picnic. "If it stays hard long enough, it can wreck everything and make you unable to ever have an erection again." Sometimes, the guy is already impotent and the perpetual hard-on is a result of impotency medication (a case of its working a little too well, I guess). For your info, contrary to a common belief, ice water is not effective in treating priapism. You need medical treatment. If the erection doesn't go away on its own, they give you an injection in the shoulder and if that doesn't work, they suck the blood out of your penis with a needle. Fun, eh?

Almost as fun as sticking pipe cleaners in your willy. Yeah, one guy did that. They didn't get stuck or anything, and he was smart enough to ball up the ends so the metal bit inside wasn't exposed. But pulling a big, fuzzy rod outta your penis can make your urethra very irritated. Another one he's heard of but hasn't seen is the old glass rod in the urethra routine. Why anyone would want to stick a breakable object - on second thought, why anyone would want to stick anything up their urethra is beyond me. Why do these guys do it? They insist it feels good, the doctor tells me. Most guys I know won't even get swabbed.

And watch what you lube up with. One guy masturbated with tiger balm. Not smart, folks. Another woman used a commonly sold body lotion that heats up. It said on the bottle that it was not intended for internal use, but why let a little vaginal burning get in the way of a good time? Read the labels, people!

Oh and while we're at it, the gerbil-up-the-ass story you've been hearing since you were a child? It's a myth, okay? "People have offered money if anyone can locate an X-ray of that and no one has ever come up with one."

Now should you find yourself with a dildo stuck up your butt, my source suggests you get a good family doctor you trust so you don't have to go to emergency. But if you can't manage that, rest assured - aside from the occasional, insensitive doctor - as you can see from my friend here, most emergency doctors have seen it all and won't be shocked.

People, please be careful out there - and keep the batteries charged in your camera.

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